ABSTRACT
Idiopathic thrombocytopenic purpura [ITP] represented the most frequent cause of children's thrombocytopenia. Until our days universal management of ITP does not exist. We performed retrospective and then prospective study of 61 children admitted for ITP during 15 years. The aim of the study was to precise the epidemiological, clinical and therapeutic profiles and propose management algorithm. The incidence of ITP was 0.34 per cent. The mean age was 6 years with male predominance. Initial thrombocytopenia was inferior than 10.000/mm3 in 44,2 per cent of cases. Spontaneous recovering was noted in 17 cases. Oral prednisone therapy with 2mg/kg/day during 21 to 35 days and 4mg/kg/day during 4 days was performed respectively in 21 and 19 cases. Intravenous immunoglobulin and methylprednisolone pulse therapy was performed respectively in 17 and 5 cases. Splenectomy was successfully performed in 3 cases. Chronic ITP was noted in 13 cases. Acute ITP without hemorrhagic syndrome should be treated in first stage with oral prednisone at 4mg/kg/day during 4 days. In case of failure, a second cure may be prescribed. If not we return to intravenous immunoglobulin
ABSTRACT
Jaundice is the common clinical sign in neonatal medicine. Its causes were dominated by ABO incompatibility. The aim of the study was to compare the effectiveness of ordinary phototherapy [OP] versus intensive phototherapy [IP] in the treatment of hyperbilirubinemia due to ABO incompatibility. A total of 104 newborns infants with haemolytic hyperbilirubinemia were evaluated. Group I [G I], 52 infants treated with OP or OP and exchange transfusion and group II [G II], 52 infants treated with IP or IP and OP. Our study demonstrated that the overall percentage decline rate of unconjugated serum bilirubin was 0.31 %/h in G I and 0.7 %/h in G II. Median duration of phototherapy was shorter in G II [16h vs 47.3h]. The use of continue OP was reduced in G II [7 vs 31 cases]. Exchange transfusion was no longer used in G I. Also we found significant decrease of the mean duration of hospitalisation in G II [4.54 vs 5.15 days] This study showed that in G II of jaundiced babies treated with IP, kernicterus was totally eliminated also the need of exchange transfusion. The use of IP reduced mother-baby separation